Kognitiiv-käitumuslik koolitusprogramm Parkinsoni tõve patsientidele ja tugiisikutele: projekt EduPark

Parkinsoni tõbi kroonilise neuroloogilise haigusena põhjustab lisaks füüsilistele vaevustele ka psühholoogilisi probleeme, millega toimetulek mõjutab otseselt patsientide elukvaliteeti. Toimetuleku soodustamiseks kasutatakse mitmesuguseid psühholoogilisi sekkumismeetodeid, sealhulgas kognitiivset käitumisteraapiat. Eesti Arst 2005; 84 (6): 402-40

Средства всережимного анализа устойчивости узлов двигательной нагрузки систем электроснабжения и условий ее обеспечения

Научный доклад посвящен проблеме достаточно полного и достоверного анализа устойчивости синхронных и асинхронных двигателей (СД и АД) узлов нагрузки систем электроснабжения (СЭС) и условий ее обеспечения, в значительной мере определяющих технологическую, экономическую эффективность и нередко безопасность функционирования большинства промышленных предприятий, особенно нефте-, газо-, химических отраслей.The scientific report is devoted to the problem of sufficiently complete and reliable analysis of the stability of synchronous and induction motors (SM and IM) load nodes of power supply systems (PSS) and its provision conditions, which to a considerable extent determine the technological, economic efficiency and often operation safety of large industrial enterprises, oil-, gas- and chemical

Video Review of Baseline Performance on Global Ratings in a Double‐Blind Placebo Surgery Trial

BACKGROUND A randomized double‐blind sham surgery‐controlled trial was conducted to determine the effectiveness of implantation of human embryonic dopamine neurons into the putamen of patients with advanced Parkinson\u27s disease (PD). The present analyses determined whether patients viewing a video of themselves performing motor activities off medications at baseline would affect self‐ratings 12 months later on the Global Rating Scale (GRS). OBJECTIVES To examine changes in GRS scores pre‐/post‐video review for the total sample; to examine differences in scores between actual implant and sham groups, as well as perceived groups pre‐ and post‐video review; to examine differences among four subgroups of patients based on actual and perceived treatment (i.e., actual implant/perceived implant). METHODS Forty participants were recruited and randomly assigned to receive either neural implantation or sham surgery. The primary outcome variable was a one‐item GRS ranging from ‐3 (much worse since surgery) to +3 (much improved since surgery). At 12 months (before the blind was lifted) patients rated themselves on the GRS before and after viewing the baseline video. RESULTS Total sample GRS scores improved after the video (P = .001). There were no differences between the actual implant and sham groups before or after the video, but there were differences between perceived groups at both times (P \u3c .001). Among subgroups, improvement after the video was found only in the group receiving the implant but who thought sham (P = .011). CONCLUSION When self‐ratings are an outcome variable, review of baseline videos is recommended before making comparative ratings

Dynamic Facial Expression of Emotion and Observer Inference

Research on facial emotion expression has mostly focused on emotion recognition, assuming that a small number of discrete emotions is elicited and expressed via prototypical facial muscle configurations as captured in still photographs. These are expected to be recognized by observers, presumably via template matching. In contrast, appraisal theories of emotion propose a more dynamic approach, suggesting that specific elements of facial expressions are directly produced by the result of certain appraisals and predicting the facial patterns to be expected for certain appraisal configurations. This approach has recently been extended to emotion perception, claiming that observers first infer individual appraisals and only then make categorical emotion judgments based on the estimated appraisal patterns, using inference rules. Here, we report two related studies to empirically investigate the facial action unit configurations that are used by actors to convey specific emotions in short affect bursts and to examine to what extent observers can infer a person's emotions from the predicted facial expression configurations. The results show that (1) professional actors use many of the predicted facial action unit patterns to enact systematically specified appraisal outcomes in a realistic scenario setting, and (2) naïve observers infer the respective emotions based on highly similar facial movement configurations with a degree of accuracy comparable to earlier research findings. Based on estimates of underlying appraisal criteria for the different emotions we conclude that the patterns of facial action units identified in this research correspond largely to prior predictions and encourage further research on appraisal-driven expression and inference

Effects of Perceived Treatment on Quality of Life and Medical Outcomesin a Double-blind Placebo Surgery Trial

Context This study was part of a large double-blind sham surgery–controlled trial designed to determine the effectiveness of transplantation of human embryonic dopamine neurons into the brains of persons with advanced Parkinson\u27s disease. This portion of the study investigated the quality of life (QOL) of participants during the 1 year of double-blind follow-up. Objectives To determine whether QOL improved more in the transplant group than in the sham surgery group and to investigate outcomes at 1 year based on perceived treatment (the type of surgery patients thought they received). Design Participants were randomly assigned to receive either the transplant or sham surgery. Reported results are from the 1-year double-blind period. Setting Participants were recruited from across the United States and Canada. Assessment and surgery were conducted at 2 separate university medical centers. Participants A volunteer sample of 40 persons with idiopathic Parkinson\u27s disease participated in the transplant ( parent ) study, and 30 agreed to participate in the related QOL study: 12 received the transplant and 18 received sham surgery. Interventions Interventions in the parent study were transplantation and sham brain surgery. Assessments of QOL were made at baseline and 4, 8, and 12 months after surgery. Main Outcome Measures Comparison of the actual transplant and sham surgery groups and the perceived treatment groups on QOL and medical outcomes. We also investigated change over time. Results There were 2 differences or changes over time in the transplant and sham surgery groups. Based on perceived treatment, or treatment patients thought they received, there were numerous differences and changes over time. In all cases, those who thought they received the transplant reported better scores. Blind ratings by medical staff showed similar results. Conclusions The placebo effect was very strong in this study, demonstrating the value of placebo-controlled surgical trials

Long-term outcome and prognosis of dissociative disorder with onset in childhood or adolescence

<p>Abstract</p> <p>Background</p> <p>In the majority of cases short-term treatment outcome of juvenile dissociative disorder is rather favourable. In contrast, the long-term course seems to be less positive, but meaningful results are still fragmentary. The aim of this follow-up study is to bridge this gap to some extent describing the long-term outcome of juvenile dissociative disorder in a clinical sample. To our knowledge there is no comparable other long-term follow-up study which is based on a case definition according to actual classification systems using standardized interviews for individual assessment of the patients at the time of follow-up.</p> <p>Methods</p> <p>The total study group was made up of all patients treated for dissociative disorder at our department for child and adolescent psychiatry between 1983 and 1992 (<it>N </it>= 62). Two of these former patients committed suicide during the follow-up period (3%). We got information on the clinical course of 27 former patients (44%). 17 out of these 27 former patients were female (63%). The mean age of onset of dissociative disorder was11.7 years and the mean follow-up time was 12.4 years. Most of the patients were reassessed personally (n = 23) at a mean age of 24.8 years using structured interviews covering dissociative disorders, other Axis I disorders and personality disorders (Heidelberg Dissociation Inventory HDI; Expert System for Diagnosing Mental Disorders, DIA-X; Structured Clinical Interview for DSM-IV, SCID-II). Social adjustment was assessed by a semi-structured interview and by patient self report (Social Adjustment Scale – Self Report, SAS-SR). Psychosocial outcome variables were additionally assessed in 36 healthy controls (67% female, mean age = 22.9 years).</p> <p>Results</p> <p>At the time of follow-up investigation 82.6% of the patients met the criteria for some form of psychiatric disorder, while 26.1% were still suffering from dissociative disorder. A total of 56.5% presented with an Axis I disorder (especially anxiety, dissociative and somatoform disorders). Personality disorders were seen in 47.8% (especially borderline, obsessive-compulsive and negativistic personality disorders). More dissociative symptoms and inpatient treatment in childhood or adolescence were significantly related to a lower level of psychosocial adjustment in adulthood.</p> <p>Conclusion</p> <p>Treatment strategies have to consider that in a significant portion of young patients initial recovery may not be stable over time. Limitations of the study refer to the small sample size and the low rate of former patients taking part in the follow-up investigation.</p

Nonverbale Indikatoren des psychischen Befindens

No abstract availabl

Multimodal expression of emotion: Affect programs or componential appraisal patterns?

In earlier work, the authors analyzed emotion portrayals by professional actors separately for facial expression, vocal expression, gestures, and body movements. In a secondary analysis of the combined data set for all these modalities, the authors now examine to what extent actors use prototypical multimodal configurations of expressive actions to portray different emotions, as predicted by basic emotion theories claiming that expressions are produced by fixed neuromotor affect programs. Although several coherent unimodal clusters are identified, the results show only 3 multimodal clusters: agitation, resignation, and joyful surprise, with only the latter being specific to a particular emotion. Finding variable expressions rather than prototypical patterns seems consistent with the notion that emotional expression is differentially driven by the results of sequential appraisal checks, as postulated by componential appraisal theorie

Are facial expressions of emotion produced by categorical affect programs or dynamically driven by appraisal?

The different assumptions made by discrete and componential emotion theories about the nature of the facial expression of emotion and the underlying mechanisms are reviewed. Explicit and implicit predictions are derived from each model. It is argued that experimental expression-production paradigms rather than recognition studies are required to critically test these differential predictions. Data from a large-scale actor portrayal study are reported to demonstrate the utility of this approach. The frequencies with which 12 professional actors use major facial muscle actions individually and in combination to express 14 major emotions show little evidence for emotion-specific prototypical affect programs. Rather, the results encourage empirical investigation of componential emotion model predictions of dynamic configurations of appraisal-driven adaptive facial actions